The New York Times reports on a battle between health care unions in California. "The S.E.I.U.'s national leadership ousted [Sal] Rosselli last year after a power struggle that ended with a jury finding that he had improperly used member dues to form a breakaway union. Shortly after being ousted, Mr. Rosselli did create a rival union, and now he is trying to lure many of his former members - 43,000 workers at Kaiser Permanente, the largest health care provider in the state. On Monday, workers at 331 Kaiser facilities across California began voting by mail on whether to bolt the S.E.I.U. and join Mr. Rosselli's group, the National Union of Healthcare Workers. A victory would give a vital boost to Mr. Rosselli's fledgling 6,000-member union, all but assuring its long-term survival" (Greenhouse, 9/13).

Los Angeles Times, on the same schism: "The stakes are huge, beyond the wards and clinics of the roughly 300 Kaiser locations taking part in the vote. An SEIU victory could help the 2-million-member union move past a period of turmoil. ... If NUHW wins, experts say, it could become a significant force in the healthcare industry, labor movement and Democratic politics even as it continues its fight with SEIU in other quarters, a competition that has disheartened some activists because it is draining time and dollars from efforts to organize nonunion workers" (Pringle, 9/13).

In other state news:

The Associated Press: "More than three-dozen indigent patients, many of them illegal immigrants, will continue to receive dialysis treatment for another year under a new agreement between Atlanta's safety net hospital and private clinics, a spokesman said Monday. Under a new agreement, Emory Healthcare will take three of the 38 patients, while Fresenius Medical Care and DaVita will take five each as charity cases, Grady Memorial Hospital spokesman Matt Gove said. That means Grady will pay nothing for the treatment of those 13 patients. The remaining 25 patients will get treatment at Fresenius at Grady's expense, as they have since October when the hospital closed its outpatient dialysis clinic for financial reasons" (Brumback, 9/13).

The Boston Globe: "Boston Medical Center announced yesterday that it would reduce its workforce by 119 people as it scrounges for savings to reverse losses projected to reach $175 million in the fiscal year that ends Sept. 30. The hospital, which employs almost 6,000 people and treats many of the city's neediest patients, said that the layoffs would account for only a small portion of the savings it needs and that it is hopeful additional Medicaid money requested earlier this year by the Patrick administration will soon be approved by the federal government. The hospital also is seeking additional payments through a lawsuit it filed last year against the state, accusing it of illegally cutting payments made to the hospital for treating thousands of poor patients. If no additional funding is found, the hospital, the state's largest provider of medical care to poverty-stricken families, projects that it will run out of cash reserves by next fall" (Lazar, 9/14).

The (Del.) News Journal: "Seniors may not be willing to accept services or devices that can help them -- such as a cane or walker -- because they see it as the first step toward loss of freedom. At the same time, health care workers are not prepared to persuade older people to take actions that will benefit them most. To overcome both barriers, a $250,000 federal grant was awarded to the Eastern Pennsylvania-Delaware Geriatric Education Center, which represents a number of health systems and universities in Delaware, Scranton and Philadelphia, including Christiana Care and Thomas Jefferson University. Funded by the federal Health Resources and Services Administration, the money will be used by the University of Delaware to develop training courses to help health professionals better meet the needs of seniors" (Ratnayake, 9/13).

The Des Moines Register: "An Iowa organization that helps the elderly and the disabled is battling the state over allegations that it has failed to account for its use of taxpayer money. The state agency known as Iowa Vocational Rehabilitation Services is refusing to pay a small nonprofit organization, the Central Iowa Center for Independent Living, for about $40,000 worth of work performed in the past two years. Central Iowa Center for Independent Living has failed to document work performed for the state and failed to cooperate with state auditors who are examining the center's finances, the Iowa attorney general alleged. The center, however, is accusing the state of intimidation and abuse of power" (Kauffman, 9/13).

The Associated Press/Idaho Statesman: "An increased number of older inmates is causing an increase in medical expenses, the Idaho Department of Correction says. The agency said there are more than 800 prisoners age 50 and older in Idaho, compared to 400 in that category a decade ago. The agency said it's currently paying about $23 million per year for medical expenses, up from the $12.1 million it paid in 2004. Officials said much of that increase is for medical care for older inmates. Different theories exist to explain the aging Idaho jail population" (9/13).

This is part of the KHN Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription.